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研究皮肤结核和非结核分枝杆菌感染:中国北京皮肤科的一项综合临床病理分析。

Investigating cutaneous tuberculosis and nontuberculous mycobacterial infections a Department of Dermatology, Beijing, China: a comprehensive clinicopathological analysis.

机构信息

Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China.

出版信息

Front Cell Infect Microbiol. 2024 Aug 23;14:1451602. doi: 10.3389/fcimb.2024.1451602. eCollection 2024.

Abstract

BACKGROUND

Cutaneous tuberculosis (CTB) and nontuberculous mycobacteria (NTM) infections present considerable diagnostic and therapeutic challenges. This study aims to provide a comprehensive clinicopathological analysis of CTB and NTM infections.

METHODS

We conducted a retrospective analysis of 103 patients diagnosed with cutaneous tuberculosis (CTB) and nontuberculous mycobacteria (NTM) infections at a Beijing dermatology department from January 2000 to January 2024. Demographic, clinical, histological, and laboratory finding data were collected. Diagnostic methods and histopathological examination were recorded. Treatment regimens and outcomes were reviewed. Descriptive statistics were used to summarize demographic and clinical data, and continuous variables expressed as means and standard deviations (SD), and categorical variables as frequencies and percentages. Statistical analyses were conducted using SPSS version 25.0.

RESULTS

The cohort included 103 patients (40.8% males and 59.2% females), with a mean age of 51.86 years. Common clinical manifestations included nodules (97.1%), erythema (74.8%), and plaques (68.9%). Histological examination revealed hyperkeratosis (68.9%), parakeratosis (23.3%), and extensive neutrophil infiltration (95.1%) were observed. Acid fast bacteria (AFB) stains and nucleic acid tests exhibited respective positivity rates of 39.6% and 52.3%, respectively. Most patients were treated with a combination of three drugs; 77.1% of patients showed improvement, with the cure rate for CTB being 20.0%.

DISCUSSION

This study highlights the diverse clinical and histological presentations of CTB and NTM infections, emphasizing the need for comprehensive diagnostic approaches. The variability in treatment regimens reflects the complex management of these infections.

CONCLUSION

The implementation of advanced molecular techniques and standardized treatment protocols is imperative for enhancing diagnostic precision and therapeutic outcomes.

摘要

背景

皮肤结核(CTB)和非结核分枝杆菌(NTM)感染带来了相当大的诊断和治疗挑战。本研究旨在对 CTB 和 NTM 感染进行全面的临床病理分析。

方法

我们对 2000 年 1 月至 2024 年 1 月在北京皮肤科诊断为皮肤结核(CTB)和非结核分枝杆菌(NTM)感染的 103 例患者进行了回顾性分析。收集了人口统计学、临床、组织学和实验室发现数据。记录了诊断方法和组织病理学检查。回顾了治疗方案和结果。使用 SPSS 版本 25.0 进行描述性统计以总结人口统计学和临床数据,连续变量表示为均值和标准差(SD),分类变量表示为频率和百分比。

结果

该队列包括 103 例患者(40.8%男性和 59.2%女性),平均年龄为 51.86 岁。常见的临床表现包括结节(97.1%)、红斑(74.8%)和斑块(68.9%)。组织学检查显示角化过度(68.9%)、角化不全(23.3%)和广泛的中性粒细胞浸润(95.1%)。抗酸杆菌(AFB)染色和核酸检测的阳性率分别为 39.6%和 52.3%。大多数患者接受三联药物治疗;77.1%的患者病情改善,CTB 的治愈率为 20.0%。

讨论

本研究强调了 CTB 和 NTM 感染的多样化临床和组织学表现,强调了综合诊断方法的必要性。治疗方案的多样性反映了这些感染的复杂管理。

结论

实施先进的分子技术和标准化治疗方案对于提高诊断精度和治疗结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d1f/11377312/3156c887784e/fcimb-14-1451602-g001.jpg

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